Teamwork Tools and Strategies

Each of the two tiers is arranged around 10 teamwork tools and strategies, including content related to the following strategies and tools from AHRQ's evidence-informed Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program:

1. Callout. A technique for loudly announcing critical information during emergent situations and when assistance is urgently needed.
2. Checkback. A closed-loop communication strategy used to verify and validate information exchanged between multiple people. The strategy involves a recipient of information restating their interpretation of information given to them and allowing the original informant the opportunity to confirm or improve understanding. If the message recipient is believed to have misunderstood the original communication, the original informant is expected to clarify and cycle through the checkback process again.
3. SBAR. A framework for standardizing communications about clinical information. Involves describing the patient situation (S), patient background (B), problem assessment (A), and recommended course of action (R). Particularly useful during the transfer of responsibility of patient care to a different provider or healthcare professional (handoff) or when describing a change in patient condition.
4. I PASS the BATON. A mnemonic useful when sharing clinical information among clinicians and healthcare professionals. Includes: introducing oneself (I); describing the patient using identifiers (P); patient assessment (A); summary of the patient situation (S); safety details such as critical lab values, allergies, etc. (S); patient background/medical history (B); actions taken or recommended (A); timing and urgency of actions (T); ownership of actions (O); and anticipated next steps (N).
5. Two Challenge Rule. A strategy for escalating concerns. Involves asserting a position or concern at least twice, especially when ignored or unheard the first time. Recommendation is to form the first "challenge" as a clarifying question to bring awareness to the situation with the second "challenge" including a statement that provides support for the concerns.
6. Power Words. The use of specific, predefined words that explicitly signal caution, warning, and danger. They are intended to catch healthcare professionals’ attention, and when integrated into safety culture are usually tied to predetermined next steps. Examples include words such as "concerned," "uncomfortable," and "safety issue," but they can be any phrase or word understood to signal a need to slow down, pivot, or otherwise bring awareness to a situation.
7. Briefs. A semistructured conversation among team members designed to improve patient care by formulating a plan and getting all parties on the same page prior to action unfolding.
8. Huddles. An ad hoc response to changing circumstances in which team members come together to regroup and generate a shared understanding of changes to the plan.
9. Debriefs. A semistructured conversation among team members to improve care by immediately reviewing performance with the intent to strategize potential improvements and reinforce desired action.
10. DESCR Script. A structured approach for delivering feedback and managing conflict constructively. Entails describing the specific situation (D), expressing concerns about the events (E), suggesting alternative actions (S), stating consequences (C), and reaching consensus and agreement for moving forward (R).